BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...

Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...

Cerebral ischemia causes the presynaptic release of tissue-type plasminogen activator (tPA). The postsynaptic density (PSD) is a postsynaptic structure that provides a matrix where signaling transduction of excitatory synapses takes place. The postsynaptic density protein-95 (PSD-95) is the most abundant scaffolding protein in the postsynaptic density (PSD), where it modulates the postsynaptic response to the presynaptic release of glutamate by regulating the anchoring of glutamate receptors to the PSD. We found that tPA induces the local translation of PSD-95 mRNA and the subsequent recruitment of PSD-95 protein to the PSD, via plasminogen-independent activation of TrkB receptors...

INTRODUCTION: Neck pain and torticollis are common symptoms in the pediatric population that rarely requires further investigation. However, in case symptoms persist, then a more meticulously approach should be considered. Underlying conditions such as infections, neck injury, autoimmune disorders or even cervical spine cancer should be excluded from diagnosis. Cervical spine cancer is a rare neurosurgical entity in the pediatric population and even rarer is atlantoaxial Ewing's sarcoma...

BACKGROUND: Cervical bilateral facet dislocations are among the most devastating spine injuries in terms of likelihood of severe neurological sequelae. More than half of patients with tetraparesis had sustained some form of bilateral facet fracture dislocation. They can occur at any level of the sub-axial cervical spine, but predominate between C5 and C7. The mechanism of these injuries has long been thought to be forceful flexion of the chin towards the chest. This "hyperflexion" hypothesis comports well with intuition and it has become dogma in the clinical literature...

Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...

OBJECTIVE: To analyze the mechanism of the halo vest-assisted Z-shape elevating-pulling reduction technique for cervical unilateral locked facets, and confirm the safety of the spinal cord under the epidural pressure that occurs during the reduction process. METHODS: Eleven osteoligamentous whole coronal and cervical spine specimens were established as skull-neck-thorax models of cervical unilateral locked facets at the C5/6 level. The halo vest-assisted Z-shape elevating-pulling reduction technique was then applied to reduce the locked facets...

"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...

Instability of the cervical spine disease requires surgery to restore stability. In the past, surgical methods were divided into two kinds of anterior and posterior. But each has its own disadvantages:anterior vertebral screw has a higher failure rate, sometimes need a second operation; and posterior pedicle screw, lateral mass screw and facet joint screw may make greater trauma, lead to longer hospitalization. For general instable cervical spine disease, according to the location of the disease, only with the anterior or posterior approach can achieve a stable effect...

OBJECTIVE: To compare the stability of subaxial cervical anterior transpedicular screw(ATPS) fixation and three traditional fixations for three-column injury. METHODS: Six specimens of cervical spine were prepared. After measurememt of the range of motion(ROM) in intact state, the specimens were made into three-column injury models. The models were reconstructed with an anterior cervical cage, and stabilized by ATPS, anterior plate(AP), anterior plate + lateral mass screw(AP+LMS) and posterior transpedicular screw(PTPS)...

BACKGROUND: Laminoplasty and laminectomy are two common surgical procedures utilized in approaching degenerative and neoplastic disease of the spinal canal. Routinely adopted instruments, such as Kerrison rongeur or high-speed drill (HSD), entail some potentially serious complications such as dura injuring and thermal and mechanical damage to neurovascular structures. We have adopted piezoelectric bone surgery, which permits a selective cut of mineralized tissues, to perform posterior procedures on the thoracic spine, where the relationship between bone and the spinal cord are critical...

BACKGROUND: Spinal cord injury (SCI) is highly incapacitating, and the neurobiological factors involved in an eventual functional recovery remain uncertain. Plastic changes to dendritic spines are closely related with the functional modifications of behavior. AIM OF THE STUDY: To explore the plastic response of dendritic spines in motoneurons after SCI. METHODS: Female rats were assigned to either of three groups: Intact (no manipulations), Sham (T9 laminectomy), and SCI (T9 laminectomy and spinal cord contusion)...

BACKGROUND: The newest CT scanners provide resolution comparable to MRIs leading many to question when and whether cervical spine MRIs are warranted. METHODS: An 8 year retrospective review identified 241 patients who underwent CT scan and MRI of the cervical spine. The initial clinical examination, cervical spine CT scan, and cervical spine MRI were compared to identify cervical spine injuries that would have been missed had the MRI not been performed. RESULTS: The CT scans were normal in 153 patients, and abnormal in 88...

BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...

BACKGROUND: Numerous studies have demonstrated the benefits of early decompression and stabilization in unstable spine injuries with incomplete neurological deficits. However, a clear consensus on timing to operative intervention still does not exist in those with a normal neurological exam and unstable spine. OBJECTIVE: To determine the optimal timing of operative intervention in traumatic spine injuries without neurological deficit. METHODS: Retrospective chart review at a single institution was performed including patients with traumatic spine injuries without neurological deficit admitted from December 2001 to August 2012...

Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...

PURPOSE: Gunshot injury to the spine can be devastating, and it has increased in the civilian population during the last decade. METHODS: We present the case of a 30-year-old male, who received a bullet in his back after exchange of fire with the police. Initial assessment revealed paraparesis with cerebrospinal fluid leak (CSF) from the bullet entry hole, CT scan showed metal debris with two bullet fragments in the L5/S1 right foramen and lateral recess, and another fragment in the central canal posteriorly, and also it revealed two fracture lines creating a right L5 "floating pedicle"...

The treatment of sports injuries in the skeletally immature has a unique set of complications. Growth deformity may occur after anterior cruciate ligament reconstruction; therefore, skeletal age is used to help guide the choice between physeal sparing and transphyseal techniques. Arthrofibrosis after tibial spine fracture fixation can be reduced by initiating immediate range of motion, and should be treated early and cautiously to avoid iatrogenic fracture. Nonunions of medial epicondyle elbow fractures are more common with nonoperative treatment, but seldom lead to clinical problems outside of certain athletes...

This study aims to evaluate the application of multimodal intraoperative monitoring (MIOM) in surgical treatment for spine burst fracture and dislocation (SBFD) patients.Eleven patients who underwent posterior reduction and instrumentation (PRI) for SBFD from June 2014 to July 2016 were included into the study. The function of the spinal cord was monitored by MIOM. The muscle strength of the lower extremities and American Spinal Injury Association (ASIA) scores were, respectively, evaluated (before surgery, and at 1, 3, 6, and 12 months after surgery)...